What preventive care covers

Preventive care is broader than an annual physical. It includes screening before symptoms appear, vaccination, counselling on behaviours such as smoking and alcohol, and periodic risk assessment that determines what else is appropriate.

Its value is specific rather than universal. Some screening clearly saves lives, some benefits only defined groups, and some tests popular in wellness marketing have never been shown to improve outcomes. Unnecessary testing carries real costs — anxiety, further procedures, and overdiagnosis.

  • Screening — blood pressure, lipids, glucose, colorectal, cervical, breast, lung for eligible smokers, bone density, hepatitis C, HIV.
  • Vaccination — influenza, COVID-19, tetanus boosters, shingles, pneumococcal, RSV for eligible groups, HPV.
  • Counselling — tobacco, alcohol, diet, activity, and depression screening.

How recommendations are made

In the US, the USPSTF reviews evidence and issues graded recommendations. A means high certainty of substantial benefit; B means high certainty of moderate benefit or moderate certainty of moderate-to-substantial benefit; C means offer selectively; D means the evidence argues against it; and an I statement means evidence is insufficient.

Under the Affordable Care Act, most US insurers cover A and B recommended services without cost sharing, though details vary. Specialty societies and the CDC vaccine advisory committee issue their own guidance, which sometimes differs.

Recommendations change as evidence develops. Colorectal screening moving from 50 to 45 for average-risk adults is a recent example, driven by rising incidence in younger adults.

A rough adult schedule

General orientation, not a personal plan — your clinician tailors it to your risk and history.

  • Blood pressure — at least every one to two years, more often if elevated.
  • Cholesterol — periodically from young adulthood, with frequency by risk.
  • Glucose or A1C — from around 35 with overweight or obesity, earlier with other risk factors.
  • Colorectal cancer — from 45 for average risk.
  • Cervical cancer — from 21, with intervals depending on test type.
  • Breast cancer — mammography beginning in the forties.
  • Lung cancer — annual low-dose CT for eligible adults with significant smoking history.
  • Bone density — from 65 for women, earlier with risk factors.
  • Vision, hearing, and dental — regularly, and increasingly important with age.

Making appointments count

The most common failure in preventive care is not refusal but drift — nobody is tracking what is due. Keeping your own record solves most of it.

  • Keep dated entries: last blood pressure, lipids, A1C, each screening test, and each vaccine.
  • Record family history specifically — which relative, which condition, at what age.
  • Bring a complete medication and supplement list to every appointment.
  • Write down your top three questions before you go in.
  • Ask what is due now, what is due next year, and what results mean.
  • Ask about the harms as well as the benefits of any test being offered.

Be cautious with direct-to-consumer whole-body scans and broad lab panels sold outside clinical guidance; they generate incidental findings that lead to further testing without evidence of benefit.